tbuckley/cabot-search huggingface dataset:
Cumulative Payments Through the Earned Income Tax Credit Program in Childhood and Criminal Conviction During Adolescence in the US
Authors: Caitlin A. Moe, Nicole L. Kovski, Kimberly Dalve, Christine Leibbrand, Stephen J. Mooney, Heather D. Hill, Ali Rowhani-Rahbar
Journal: JAMA Network Open (2022)

Importance Childhood poverty is associated with poor health and behavioral outcomes. The Earned Income Tax Credit (EITC), first implemented in 1975, is the largest cash transfer program for working families with low income in the US. Objective To assess whether cumulative EITC payments received during childhood are associated with the risk of criminal conviction during adolescence. Design, Setting, and Participants In this cohort study, the analytic sample consisted of US children enrolled in the 1979 National Longitudinal Study of Youth. The children were born between 1979 and 1998 and were interviewed as adolescents (age 15-19 years) between 1994 and 2016. Data analyses were performed from May 2021 to September 2022. Exposure Cumulative simulated EITC received by the individual’s family from birth through age 14 years. Main Outcomes and Measures The main outcome was dichotomous, self-reported conviction for a crime during adolescence (age 14-18 years). A cumulative, simulated measure of mean EITC benefits received by a child’s family from birth through age 14 years was derived from federal, state, and family-size differences in EITC eligibility and payments during the study period to capture EITC benefit variation due to differences in policy parameters but not endogenous factors such as changes in household income. Logistic regression models with fixed effects for state and year and robust SEs clustered by mother estimated relative risk of adolescent conviction. Models were adjusted for state-, mother-, and child-level covariates. Results The analytical sample consisted of 5492 adolescents born between 1979 and 1998; 2762 (50.3%) were male, 1648 (30.0%) were Black, 1125 (20.5%) were Hispanic, and 2719 (49.5%) were not Black or Hispanic. Each additional $1000 of EITC received during childhood was associated with an 11% lower risk of self-reported criminal conviction during adolescence (adjusted odds ratio, 0.89; 95% CI, 0.84-0.95). Adjusted risk differences were larger among boys (−14.2 self-reported convictions per 1000 population [95% CI, −22.0 to −6.3 per 1000 population]) than among girls (−6.2 per 1000 population [95% CI, −10.7 to −1.6 per 1000 population]). Conclusions and Relevance The findings suggest that income support from the EITC may be associated with reduced youth involvement with the criminal justice system in the US. Cost-benefit analyses of the EITC should consider these longer-term and indirect outcomes.
Use of Computed Tomography of the Head in Patients With Acute Atraumatic Altered Mental Status
Authors: Roshan Acharya, Smita Kafle, Dhan Bahadur Shrestha, Yub Raj Sedhai, Meera Ghimire, Kishor Khanal, Queen Baba Malla, Uttam Nepal, Rojina Shrestha, Badri Giri
Journal: JAMA Network Open (2022)

Importance The usefulness of computed tomography of the head (CTH) in patients with acute-onset atraumatic altered mental status (AMS) is poorly understood, but use in these patients remains high. Objective To evaluate the use of CTH (event rate) in patients with AMS and the positive outcome event rate of the performed CTH studies. Data Sources The PubMed/MEDLINE, PubMed Central, Embase, and CINAHL databases were searched using predefined Boolean parameters. All studies that met inclusion criteria until January 31, 2022, were included. Study Selection Randomized clinical trials and observational, cohort, and case-control studies were included. Conference abstracts, reviews, letters, case reports, case series, systematic literature, and meta-analyses were excluded. Data Extraction and Synthesis The systematic literature review was performed per Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Data were independently extracted by 2 authors. Data were pooled using a random-effects method. Main Outcomes and Measures Event rate of CTH use in patients with acute atraumatic AMS. The CTH event rates and positive CTH event rates were calculated with 95% CIs. Results Of 9338 studies identified, 26 qualified for the systematic review and 25 for the meta-analysis. The 25 studies in the meta-analysis included a total of 79 201 patients. The CTH event rate was 94% (proportion, 0.94; 95% CI, 0.76-1.00), and the positive CTH event rate was 11% (proportion, 0.11; 95% CI, 0.07-0.15). There was significant heterogeneity among the studies included ( I 2 &amp;amp;gt; 50%, P &amp;amp;lt; .001), for which a random-effects model was used. There was significant publication bias, as evident by an asymmetric funnel plot. There was no fluctuation of the results during the sensitivity analysis, which reassured the reliability of the data. Conclusions and Relevance In this meta-analysis, CTH use among patients with acute-onset atraumatic AMS was very high with a low yield. Large-scale studies are needed to guide clinical decision-making in such a situation.
Toward Risk Assessment for Amniotic Fluid Embolisms
Authors: Paolo Ivo Cavoretto, Patrizia Rovere-Querini, Massimo Candiani
Journal: JAMA Network Open (2022)

Genevieve R. Mazza, MD; Ariane C. Youssefzadeh, MD; Maximilian Klar, MD, MPH; Mirjam Kunze, MD; Shinya Matsuzaki, MD, PhD; Rachel S. Mandelbaum, MD; Joseph G. Ouzounian, MD, MBA; Koji Matsuo, MD, PhD
Evaluation of Industry Payments to US Advanced Practice Clinicians in 2021
Authors: Armaan Singh, Max J. Hyman, Parth K. Modi
Journal: JAMA Network Open (2022)

Importance Advanced practice clinicians (APCs) are a growing part of the US health care system, and their financial relationships with pharmaceutical and medical device companies have not been well studied. Objectives To examine the value, frequency, and types of payments made to APCs and the association of state scope-of-practice laws with these payments. Design, Setting, and Participants This cross-sectional study used 2021 Open Payments Program data to analyze payments from pharmaceutical or medical device companies to physicians or APCs between January 1 and December 31, 2021. Doctors of medicine and osteopathy were categorized as physicians, and nurse practitioners, physician assistants, clinical nurse specialists, certified registered nurse anesthetists, certified nurse midwives, and anesthesiologist assistants as APCs. Main Outcomes and Measures The total value and total number of payments were calculated in aggregate and per clinician for each type of APC, all APCs, and physicians. These calculations were repeated by submitting manufacturer, form of payment, nature of payment, and state scope-of-practice law for nurse practitioners, physician assistants, and physicians. Results A total of 412 000 physicians and 232 000 APCs collectively received $1.99 billion in payments from industry in 2021, of which APCs received $121 million (6.1%). The median total value of payments per clinician for physicians was $167 (IQR, $45-$712) and for APCs was $117 (IQR, $33-$357). The median total number of payments per clinician was equal for physicians and APCs (n = 4). The most common payments to APCs included food and beverage ($69 million [57.6%]), compensation for services other than consulting ($32 million [26.4%]), and consulting fees ($8 million [6.6%]). Advanced practice clinicians in states with the most restrictive scope-of-practice laws received 15.9% lower total value of payments than those in the least restrictive states ( P = .002). Physician assistants received 7.6% ( P = .005) higher value and 18.1% ( P &amp;amp;lt; .001) greater number of payments than nurse practitioners. Conclusions and Relevance In this cross-sectional study, 232 000 APCs collectively received $121 million in industry payments in 2021. The frequency of industry interactions with APCs was similar to that for physicians, but the average value was lower. The greater value of payments to APCs who practice in states with the least restrictive scope-of-practice laws suggests that industry payments may be related to clinician autonomy.
Race-Dependent Association of High-Density Lipoprotein Cholesterol Levels With Incident Coronary Artery Disease
Authors: Neil A. Zakai, Jessica Minnier, Monika M. Safford, Insu Koh, Marguerite R. Irvin, Sergio Fazio, Mary Cushman, Virginia J. Howard, Nathalie Pamir
Journal: Journal of the American College of Cardiology (2022)

Plasma lipids are risk factors for coronary heart disease (CHD) in part because of race-specific associations of lipids with CHD. The purpose of this study was to understand why CHD risk equations underperform in Black adults. Between 2003 and 2007, the REGARDS (REasons for Geographic and Racial Differences in Stroke) cohort recruited 30,239 Black and White individuals aged ≥45 years from the contiguous United States. We used Cox regression models adjusted for clinical and behavioral risk factors to estimate the race-specific hazard of plasma lipid levels with incident CHD (myocardial infarction or CHD death). Among 23,901 CHD-free participants (57.8% White and 58.4% women, mean age 64 ± 9 years) over a median 10 years of follow-up, 664 and 951 CHD events occurred among Black and White adults, respectively. Low-density lipoprotein cholesterol and triglycerides were associated with increased risk of CHD in both races (P interaction by race >0.10). For sex-specific clinical HDL-C categories: low HDL-C was associated with increased CHD risk in White (HR: 1.22; 95% CI: 1.05-1.43) but not in Black (HR: 0.94; 95% CI: 0.78-1.14) adults (P interaction by race = 0.08); high HDL-C was not associated with decreased CHD events in either race (HR: 0.96; 95% CI: 0.79-1.16 for White participants and HR: 0.91; 95% CI: 0.74-1.12 for Black adults). Low-density lipoprotein cholesterol and triglycerides modestly predicted CHD risk in Black and White adults. Low HDL-C was associated with increased CHD risk in White but not Black adults, and high HDL-C was not protective in either group. Current high-density lipoprotein cholesterol–based risk calculations could lead to inaccurate risk assessment in Black adults.
Concealed Cardiomyopathy in Autopsy-Inconclusive Cases of Sudden Cardiac Death and Implications for Families
Authors: Julia C. Isbister, Natalie Nowak, Laura Yeates, Emma S. Singer, Raymond W. Sy, Jodie Ingles, Hariharan Raju, Richard D. Bagnall, Christopher Semsarian
Journal: Journal of the American College of Cardiology (2022)
​​​The UK asylum accommodation system—a child safeguarding crisis and human rights failure
Authors: Amy Stevens, Amaran Uthayakumar-Cumarasamy
Journal: BMJ (2022)

The UK asylum accommodation system-a child safeguarding crisis and human rights failureThe UK has repeatedly failed to meet the safeguarding needs of children seeking asylum, say Amy Stevens and Amaran Uthayakumar-Cumarasamy Amy Stevens, 1, 2 Amaran Uthayakumar-Cumarasamy 3, 2 "There are a lot of children, they shouldn't be here.They should be in a school, not prison."So reads the note in a bottle that was thrown over the fence by a young girl to journalists and protesters at the Manston processing centre in early November. 1 Her words provide insight into a system that is inflicting untold harm on children and young people who are already made vulnerable by the life experiences that have forced them to flee their home country and undertake dangerous and traumatic migration journeys.
A Practical Approach to Left Main Coronary Artery Disease
Authors: Laura J. Davidson, Joseph C. Cleveland, Frederick G. Welt, Saif Anwaruddin, Robert O. Bonow, Michael S. Firstenberg, Mario F. Gaudino, Bernard J. Gersh, Kendra J. Grubb, Ajay J. Kirtane, Jacqueline E. Tamis-Holland, Alexander G. Truesdell, Stephan Windecker, Roza A. Taha, S. Chris Malaisrie
Journal: Journal of the American College of Cardiology (2022)
Efficacy, duration of use and safety of glucocorticoids: a systematic literature review informing the 2022 update of the EULAR recommendations for the management of rheumatoid arthritis
Authors: Sytske Anne Bergstra, Alexandre Sepriano, Andreas Kerschbaumer, Désirée van der Heijde, Roberto Caporali, Christopher John Edwards, Patrick Verschueren, Savia de Souza, Janet E Pope, Tsutomu Takeuchi, Kimme L Hyrich, Kevin L Winthrop, Daniel Aletaha, Tanja A Stamm, Jan W Schoones, Josef S Smolen, Robert B M Landewé
Journal: Annals of the Rheumatic Diseases (2022)

This systematic literature review (SLR) regarding the efficacy, duration of use and safety of glucocorticoids (GCs), was performed to inform the 2022 update of the EULAR recommendations for the management of rheumatoid arthritis (RA). Studies on GC efficacy were identified from a separate search on the efficacy of disease-modifying antirheumatic drugs (DMARDs). A combined search was performed for the duration of use and safety of GCs in RA patients. Dose-defined and time-defined GC treatment of any dose and duration (excluding intra-articular GCs) prescribed in combination with other DMARDs were considered. Results are presented descriptively. Two included studies confirmed the efficacy of GC bridging as initial therapy, with equal efficacy after 2 years of initial doses of 30 mg/day compared with 60 mg/day prednisone. Based on a recently performed SLR, in clinical trials most patients starting initial GC bridging are able to stop GCs within 12 (22% patients continued on GCs) to 24 months (10% patients continued on GCs). The safety search included 12 RCTs and 21 observational studies. Well-known safety risks of GC use were confirmed, including an increased risk of osteoporotic fractures, serious infections, diabetes and mortality. Data on cardiovascular outcomes were Inconsistent. Overall, safety risks increased with increasing dose and/or duration, but evidence on which dose is safe was conflicting. In conclusion, this SLR has confirmed the efficacy of GCs in the treatment of RA. In clinical trials, most patients have shown to be able to stop GCs within 12–24 months. Well-known safety risks of GC use have been confirmed, but with heterogeneity between studies.
Increasing Societal Benefit From Cardiovascular Drugs
Authors: Marcello Tonelli, Sharon Straus
Journal: Circulation (2022)

During the past few years, several innovative treatments for noncommunicable chronic disease have become available, including SGLT2i (sodium-glucose cotransporter-2 inhibitors), GLP-1a (glucagon-like-peptide 1 agonists), ARNI (angiotensin receptor-neprilysin inhibitors), and finerenone, a selective nonsteroidal mineralocorticoid receptor antagonist. Each of these medications improves clinically relevant outcomes when added to existing therapies, and the indications for their use are rapidly expanding. Because existing drug regimens are already complex and costly, ensuring that society derives the maximal benefit from these new agents represents a major challenge. This Primer discusses how society can meet this challenge, which we address in terms of 5 principles: maximizing benefit, minimizing harm, optimizing uptake, increasing value for money, and ensuring equitable access. The Primer is most relevant for stakeholders in high-income countries, but the principles are broadly applicable to stakeholders in other settings, including low- and middle-income countries. We have focused the discussion on SGLT-2i, but the 5 principles herein could be used with reference to ARNI, finerenone, or any other health product.
Mapping the global distribution of spotted fever group rickettsiae: a systematic review with modelling analysis
Authors: Yuan-Yuan Zhang, Yan-Qun Sun, Jin-Jin Chen, Ai-Ying Teng, Tao Wang, Hao Li, Simon I Hay, Li-Qun Fang, Yang Yang, Wei Liu
Journal: The Lancet Digital Health (2022)

BackgroundEmerging and re-emerging spotted fever group (SFG) rickettsioses are increasingly recognised worldwide as threats to public health, yet their global distribution and associated risk burden remain poorly understood.MethodsIn this systematic review and modelling analysis, we mapped global distributions of all confirmed species of SFG rickettsiae (SFGR) detected in animals, vectors, and human beings, using data collected from the literature. We assessed ecological drivers for the distributions of 17 major SFGR species using machine learning algorithms, and mapped model-predicted risks.FindingsBetween Jan 1, 1906, and March 31, 2021, we found reports of 48 confirmed SFGR species, with 66 133 human infections worldwide, with a large spatial variation across the continents. 198 vector species were detected to carry 47 of these Rickettsia spp. (146 ticks, 24 fleas, 15 mosquitoes, six mites, four lice, two keds, and one bug). Based on model-predicted global distributions of the 17 major SFGR species, we found five spatial clusters aggregated by ecological similarity in terms of environmental and ecoclimatic features. Rickettsia felis is the leading SFGR species to which 4·4 billion (95% CI 3·8–5·3 billion) people are at risk, followed by Rickettsia conorii (3·7 billion) and Rickettsia africae (3·6 billion).InterpretationThe wide spectrum of vectors is contributing substantially to the increasing incidence of SFGR infections among humans. Awareness, diagnosis, and surveillance of SFGR infections should be improved in the high-risk regions, especially in areas where human infections are underreported.FundingNational Key Research and Development Program of China.
<i>QuickStats:</i> Death Rates for Drug Overdose* Among Persons Aged 25–44 Years, by Race and Ethnicity†— United States, 2000–2020
Journal: MMWR Morbidity and Mortality Weekly Report (2022)

Black, non-Hispanic White, non-Hispanic Hispanic * Drug overdose deaths were identified using the following International Classification of Diseases, Tenth Revision codes: X40-X44 (Unintentional), X60-X64 (Suicide), X85 (Homicide), and Y10-Y14 (Undetermined).† Rates for 2000-2017 are based on multiple-race mortality data bridged to single-race categories, according to the 1977 Office of Management and Budget (OMB) standard for the classification of race.Rates for 2018-2020 were based on 1997 OMB standards and might differ slightly compared with the 1977 standards.https:// www.cdc.gov/nchs/data/nvsr/nvsr70/nvsr70-03-508.pdfFrom 2000 to 2013, the rate for drug overdose death increased for non-Hispanic White (White) persons aged 25-44 years but was stable for non-Hispanic Black (Black) and Hispanic persons in this age group.From 2013 to 2020, rates increased for all groups, from 30.2 to 63.8 per 100,000 population for White persons, from 12.0 to 50.7 for Black persons, and from 9.6 to 29.9 for Hispanic persons.From 2019 to 2020, all three racial and ethnic groups experienced the largest annual increase in drug overdose death rates (56% among Black, 41% among Hispanic, and 28% among White persons).In 2020, the drug overdose death rate for White persons was the highest among all groups, followed by Black and Hispanic persons.
Informing the Debate about Telemedicine Reimbursement — What Do We Need to Know?
Authors: Ateev Mehrotra, Lori Uscher-Pines
Journal: New England Journal of Medicine (2022)

Interview with Dr. Ateev Mehrotra on federal pandemic-era telemedicine policies and research that could help inform permanent regulations. (09:48)Download Short-term extensions of pandemic-era telemedicine regulations create an opportunity to answer critical questions and ensure that permanent policies will be informed by the best possible evidence.
Nucleotide binding as an allosteric regulatory mechanism for <i>Akkermansia muciniphila</i> β- <i>N</i> -acetylhexosaminidase Am2136
Authors: Chang-Cheng Li, Huan Yi, Yan-Mei Wang, Xin-Yue Tang, Yi-Bo Zhu, Ying-Jie Song, Ning-Lin Zhao, Qin Huang, Xing-Yu Mou, Gui-Hua Luo, Tong-Gen Liu, Gang-Long Yang, Yu-Jiao Zeng, Li-Jie Wang, Hong Tang, Gang Fan, Rui Bao
Journal: Gut Microbes (2022)

β-N-acetylhexosaminidases (EC3.2.1.52), which belong to the glycosyl hydrolase family GH20, are important enzymes for oligosaccharides modification. Numerous microbial β-N-acetylhexosaminidases have been investigated for applications in biology, biomedicine and biotechnology. Akkermansia muciniphila is an anaerobic intestinal commensal bacterium which possesses specific β-N-acetylhexosaminidases for gut mucosal layer colonization and mucin degradation. In this study, we assessed the in vitro mucin glycan cleavage activity of the A. muciniphila β-N-acetylhexosaminidase Am2136 and demonstrated its ability that hydrolyzing the β-linkages joining N-acetylglucosamine to a wide variety of aglycone residues, which indicated that Am2136 may be a generalist β-N-acetylhexosaminidase. Structural and enzyme activity assay experiments allowed us to probe the essential function of the inter-domain interactions in β23-β33. Importantly, we revealed that the hydrolysis activity of Am2136 was enhanced by nucleotides. We further speculated that this activation mechanism might be associated with the conformational motions between domain III and IV. To our knowledge, this is the first report of nucleotide effector regulated β-N-acetylhexosaminidase, to reveal its novel biological functions. These findings contribute to understanding the distinct properties within the GH20 family and lay a certain foundation to develop controllable glycan hydrolyzing catalysts.Abbreviations: OD600 - optical cell densities at 600 nm; LB - Luria–Bertani; IPTG - isopropyl β-D-1-thiogalactopyranoside; PMSF - phenylmethanesulfonyl fluoride; rmsd - root mean square deviation; GlcNAc - N-acetyl-β-D-glucosamine; GalNAc - N-acetyl-β-D-galactosamine; Gal - galactose
Effect of Irrigation Fluid Temperature on Recurrence in the Evacuation of Chronic Subdural Hematoma
Authors: Andreas Bartley, Jiri Bartek, Asgeir S. Jakola, Jimmy Sundblom, Marie Fält, Petter Förander, Niklas Marklund, Magnus Tisell
Journal: JAMA Neurology (2022)

The effect of a physical property of irrigation fluid (at body vs room temperature) on recurrence rate in the evacuation of chronic subdural hematoma (cSDH) needs further study.To explore whether irrigation fluid temperature has an influence on cSDH recurrence.This was a multicenter randomized clinical trial performed between March 16, 2016, and May 30, 2020. The follow-up period was 6 months. The study was conducted at 3 neurosurgical departments in Sweden. All patients older than 18 years undergoing cSDH evacuation during the study period were screened for eligibility in the study.The study participants were randomly assigned by 1:1 block randomization to the cSDH evacuation procedure with irrigation fluid at room temperature (RT group) or at body temperature (BT group).The primary end point was recurrence requiring reoperation within 6 months. Secondary end points were mortality, health-related quality of life, and complication frequency.At 6 months after surgery, 541 patients (mean [SD] age, 75.8 [9.8] years; 395 men [73%]) had a complete follow-up according to protocol. There were 39 of 277 recurrences (14%) requiring reoperation in the RT group, compared with 16 of 264 recurrences (6%) in the BT group (odds ratio, 2.56; 95% CI, 1.38-4.66; P < .001). There were no significant differences in mortality, health-related quality of life, or complication frequency.In this study, irrigation at body temperature was superior to irrigation at room temperature in terms of fewer recurrences. This is a simple, safe, and readily available technique to optimize outcome in patients with cSDH. When irrigation is used in cSDH surgery, irrigation fluid at body temperature should be considered standard of care.ClincalTrials.gov Identifier: NCT02757235.
Quality-of-life outcomes in older patients with early-stage rectal cancer receiving organ-preserving treatment with hypofractionated short-course radiotherapy followed by transanal endoscopic microsurgery (TREC): non-randomised registry of patients unsuitable for total mesorectal excision
Authors: Alexandra Gilbert, Victoria Homer, Kristian Brock, Stephan Korsgen, Ian Geh, James Hill, Talvinder Gill, Paul Hainsworth, Matthew Tutton, Jim Khan, Jonathan Robinson, Mark Steward, Christopher Cunningham, Manjinder Kaur, Laura Magill, Ann Russell, Philip Quirke, Nicholas P West, David Sebag-Montefiore, Simon P Bach
Journal: The Lancet Healthy Longevity (2022)